Article Figures & Data
Figures
- Fig 1.
Comparison of the aneurysm neck as imaged by 3DRA (A) and 2D DSA (B). The 3DRA image suggests a wider neck than 2D DSA, which is expressed in the original 3DRA-derived vascular model (C). D, The vascular model after modification.
- Fig 2.
Illustration of the hemodynamic features displayed for comparison of case 7. A, Isosurface of the maximal 25% of the flow magnitude within the aneurysm as used in the assessment of the inflow jet. B, Streamlines of the flow used in the assessment of the main vortices.
- Fig 3.
Eight cases in which the 3DRA-derived vascular models were considered to disagree with 2D DSA. From left to right: the original vascular model; the working projection DSA; the modified 3DRA-derived vascular model.
- Fig 4.
Hemodynamic features in original (left) and modified vascular models (right). Case 1 shows a similar impingement zone and WSS distribution, flow velocity, and direction of the inflow jet. Case 2 shows an increase in maximal WSS, unchanged flow velocity, and direction of the inflow jet. Case 4 shows an increased maximal WSS, an increased impingement zone, an increased maximal flow velocity, and a change in inflow jet position. Case 6 shows a decrease in maximal WSS, a change in impingement zone, and a change in the maximal flow velocity and the position of the inflow jet.
- Fig 5.
Inflow jet in the original model (A) and modified model (B) showing a considerable difference in the inflow jet position of case 6. Both inflow jets are shown in superposition in image C.
- Fig 6.
A change in position of the impingement zone (IZ) between the original (A) and modified (B) vascular model after modification of case 5.
- Fig 7.
Schematic front view (left), bottom view (middle), and side view (right) of an idealized aneurysm and its parent artery. The front view would be chosen as the working projection. This figure shows that the parent artery is closer to the artery in the front view (area A) than perpendicular to the working projection (area B), suggesting that the blurring of the neck is more severe in this direction.
Tables
- Table 1:
Demographic and clinical data of the 8 patients with aneurysm neck size overestimation in the 3DRA-derived vascular models
Case Location Age/Sex Aneurysm Size (mm) Original Neck Diameter (mm) Absolute Neck Diameter Reduction (mm) Relative Neck Diameter Reduction 1 AcomA 56/F 5.9 5.24 0.77 15% 2 AcomA 27/M 6.9 4.28 0.34 8% 3 BA 53/F 11.0 6.86 0.54 8% 4 MCA 41/M 4.5 2.86 0.82 29% 5 PcomA 57/F 17.9 6.66 1.20 18% 6 BA 50/F 6.0 3.86 1.19 31% 7 MCA 58/M 12.8 6.79 0.70 10% 8 PA 39/F 6.1 3.76 1.20 32% Average 48 8.9 5.04 0.85 19% Minimum 27 5.9 2.86 0.34 8% Maximum 58 17.9 6.86 1.20 32% Standard deviation 11 4.6 1.58 0.32 10% Note:—Aneurysm size is the largest aneurysm diameter. Neck diameters were measured in the working projection. AcomA indicates anterior communicating artery; BA, basilar artery; PA, pericallosal artery; PcomA: posterior communicating artery.
- Table 2:
Consensus measurements of hemodynamic changes as a result of a correction of the 3DRA surface neck
Case Inflow Jet Impingement Zone Low WSS Zone Vortices Change Change in Position Change in Size Change in Position Change in Size Change in Position Change in Size 1 No Narrower (2) No Smaller (3) No Larger (1) No 2 No Narrower (2) No Smaller (5) No Larger (4) No 3 No Wider (2) Yes (3) Larger (3) Yes (4) No No 4 Yes (2) Wider (2) No Larger (5) Yes (4) Smaller (5) No 5 No Narrower (2) Yes (5) Smaller (5) No Larger (5) No 6 Yes (2) Narrower (3) Yes (5) Larger (5) Yes (4) Larger (5) No 7 No Narrower (5) No Smaller (2) Yes (5) Larger (5) No 8 No Wider (1) No Smaller (2) No Larger (3) No Note:—The significance scoring is given in brackets (1 = little significance; 5 = great significance).
- Table 3:
Quantitative differences in hemodynamic patterns of the original and modified vascular models
Case Relative Increase in Maximal Inflow Velocity Relative Increase in Maximal WSS Distance Between Impingement Zones (mm) Region Classification of Impingement Zone (Original/Modified) 1 −2.7% +0.7% 0.25 Body/Body 2 −5.4% −17.7% 0.27 Neck/Neck 3 2.6% +22.0% 1.14 Dome/Lobulation 4 8.3% +98.0% 0.46 Body/Body 5 −0.3% +1.5% 6.51 Body/Dome 6 9.3% −18.4% 0.47 Neck/Neck 7 −1.6% −4.5% 0.27 Neck/Neck 8 3.8% +6.3% 0.23 Dome/Dome κ Weighted κ Inflow jet position 0.63 (0.36) 0.16 (0.11) Inflow jet size NA 0.67 (0.22) Impingement zone position 1 0.89 (0.06) Impingement zone size 1 0.62 (0.12) Visible change in low WSS 1 NA Change in low WSS position 0.67 (0.20) 0.50 (0.16) Change in low WSS size 1 0.63 (0.23) Number of vortices 1 NA Note:—The weighted interobserver agreement is measured including the significance of a reported change in a hemodynamic feature. Standard error is given between parentheses. NA indicates not available.
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